2013—2018年医院临床分离细菌种类分布及耐药性监测

目的 了解2013-2018年医院临床分离细菌的种类分布和耐药性，为临床合理使用抗菌药物提供参考依据。方法 回顾性分析某院2013-2018年各临床科室住院患者培养标本分离的细菌菌株，包括菌种名称、来源标本和药敏情况，应用WHONET 5.6和SPSS 20.0软件对数据进行统计分析。结果 2013-2018年共分离细菌5 014株，主要为革兰阴性（G^-）菌（3 797株，占75.73%）。检出主要细菌为大肠埃希菌（1 182株，占23.57%）、肺炎克雷伯菌（669株，占13.34%）和铜绿假单胞菌（408株，占8.14%）等。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗生素较敏感，耐药率均<10%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为29.31%和20.88%。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率较高，分别为61.71%和53.74%。金黄色葡萄球菌对苯唑西林的耐药率为42.14%，未检出对万古霉素和利奈唑胺耐药的菌株。结论 该院近年来临床分离常见细菌的耐药情况较平稳，整体有下降趋势。

Distribution and antimicrobial resistance of clinically isolated bacteria in a hospital from 2013 to 2018

Objective To investigate the distribution and antimicrobial resistance of clinically isolated bacteria in a hospitals from 2013 to 2018, and provide reference for rational use of antimicrobial agents in clinic. Methods Bacterial strains isolated from specimens of hospitalized patients in different clinical departments in a hospital from 2013 to 2018 were analyzed retrospectively, including the name of strains, specimen sources and antimicrobial susceptibi-lity, data were analyzed by WHONET 5.6 and SPSS 20.0 software. Results A total of 5 014 strains of bacteria were isolated in 2013-2018, 3 797 (75.73%) of which were gram-negative bacteria. The main isolated bacteria were Escherichia coli (n=1 182, 23.57%), Klebsiella pneumoniae (n=669, 13.34%), and Pseudomonas aeruginosa (n=408, 8.14%). Escherichia coli and Klebsiella pneumoniae were sensitive to carbapenems, antimicrobial resistance rates were all<10%. Resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 29.31% and 20.88% respectively. Resistance rates of Acinetobacter baumannii to imipenem and meropenem were 61.71% and 53.74% respectively. Resistance rate of Staphylococcus aureus to oxacillin was 42.14%, vancomycin and line-zolid-resistant strains was not found. Conclusion Antimicrobial resistance of clinically isolated common bacteria in this hospital is relatively stable in recent years, with an overall downward.